APPLYING A RACE(ISM)-CONSCIOUS ADAPTATION OF THE CFIR FRAMEWORK TO UNDERSTAND IMPLEMENTATION OF A SCHOOL-BASED EQUITY-ORIENTED INTERVENTION

Objectives: To use the Consolidated Framework for Implementation Research (CFIR) adapted to a race-conscious frame to understand ways that structural racism interacts with intervention implementation and uptake within an equity-oriented trial designed to enhance student-school connectedness. Design: Secondary analysis of qualitative implementation data from Project TRUST (Training for Resiliency in Urban Students and Teachers), a hybrid effectiveness-implementation, community-based participatory intervention. Setting: Ten schools across one urban school district. Methods: We analyzed qualitative observational field notes, youth and parent researcher reflections, and semi-structured interviews with community-academic researchers and school-based partners within CFIR constructs based on framing questions using a Public Health Critical Race Praxis approach. Results: Within most CFIR constructs and sub-constructs, we identified barriers to implementation uptake not previously recognized using standard race-neutral definitions. Themes that crossed constructs included: 1) Leaders' willingness to examine Black, Indigenous, People of Color (BIPOC) student and parent experiences of school discrimination and marginalization had a cascading influence on multiple factors related to implementation uptake; 2) The race/ethnicity of the principals was related to intervention engagement and intervention uptake, particularly at the extremes, but the relationship was complex; 3) External change agents from BIPOC communities facilitated intervention uptake in indirect but significant ways; 4) Highly networked implementation champions had the ability to enhance commitment to intervention uptake; however, perceptions of these individuals and the degree to which they were networked was highly racialized. Conclusions: Equity-oriented interventions should consider structural racism within the CFIR model to better understand intervention uptake.

Automated summary

The study demonstrates the significant impact of structural racism on intervention implementation and uptake within a trial designed to enhance student-school connectedness. By adapting the Consolidated Framework for Implementation Research to a race-conscious frame, findings include the cascading influence of leaders' examination of BIPOC student and parent experiences, the complex relationship between principals' race/ethnicity and intervention engagement, the facilitative role of external change agents from BIPOC communities, and the racialized perceptions of highly networked implementation champions in enhancing intervention uptake.